Reply To: Why colchicine with Allopurinol and Indomethacin?

Stopping Gout Together Forums Help My Gout! The Gout Forum Why colchicine with Allopurinol and Indomethacin? Reply To: Why colchicine with Allopurinol and Indomethacin?

Keith Taylor

Colchicine Safety
Linda is absolutely right to warn about colchicine safety. It works by poisoning the immune system. The overview of that is, it’s a balance of pain control over toxicity risks. This is common in treatment of many severe pain diseases.

I look at it this way:
If colchicine helps you during your uric acid lowering treatment, it’s a good thing. But, I have several caveats:
1. Uric acid lowering should be managed properly to make the period when you get benefits from colchicine as short as possible.
2. Never take more than 2 colchicine in 24 hours.
3. Avoid colchicine if your immune system is compromised. That might mean some other viral or bacterial disease that you are fighting. It also might mean exposure to sick people.
4. Colchicine should be part of a comprehensive pain management package that also reduces inflammation, and blocks residual pain. Without that, patients are tempted to take too much colchicine, which is wrong. It’s wrong because it’s not safe, but also colchicine above 2 per day has little or no effect, other than to poison you.

Colchicine during lowering uric acid
Kevin, Great news with your uric acid test results! 🙂
I think it’s important to understand why you take colchicine when you start with allopurinol. Until most of your uric acid burden has reduced, you are at risk of a gout flare. It takes time for old uric acid crystals to dissolve. The way to reduce that time is to go even lower on your uric acid levels, but that’s a different topic.

What you should find, is a decreasing need for colchicine. There are different ways to manage that. You could go ‘as required’ now, or reduce to one tablet per day. Whichever you chose, I think it’s best to make a note of your gout symptoms. You can post that here if you like. Or, I’ll set up a personal profile area for you. That gives you historic data to help planning colchicine dose in future. It also focuses the mind. When you reduce dose, or go ‘as required’, it’s important to act fast if you do get signs of a gout flare.

Personally, I reduced my colchicine to zero within a few weeks of starting allopurinol. But, there’s no right or wrong way. Just reduce colchicine at your own pace, Kevin. You can be happy in the knowledge that uric acid is reducing. Any discomfort you get at your uric acid levels is a sign that old crystals are dissolving. It will become less as the days pass.

Thanks for inspiring